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CITY O FBL_A IR I
218 S. 16TH STREET
BL.AIR, NEBRASKA 68008
wilding Permit Application (402) 426 -4 1 91- P hone
(402) 426 -4195 FAX
MS- 2014 -00434 A ro a�``�
�sa of � www.blairnebraska.vrg '
=06/1912014 MISC Residential June 19, 2014
.0— LOCATIONOFIMPROVEMENT
�� 9505 Cord 29, Blair, NE 68008
ARCHITECT:
GENERAL. Pyramid Roofing
T } OWNER: John R And Julie C Henton CONTRACTOR: 150 S Saddlecreek Rd
Omaha, NE 68106
29 9505 Co Rd
` BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 06/1812016
9505Gprd 29- 140619W2014 Storm Damage
ESTIMATED COMPLETION DATE 1 2/3112014
DESCRIPTION OF WORK
Roofing, gutters, siding, and metal out - buildings
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED, NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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1. No work will be started before a permit is ISSUED AND POSTED,
2. For commercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
4. The undersigned owner or agent understands and acknowledges this building permit application does not constitute issuance of
this building permit. It is further understood that construction covered by this permit application shall not be commenced until a
copy of a permit signed by the Building Inspector is issued.
5. The undersigned owner or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance with the codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or without the intention of the undersigned or any alteration or change from this application without approval of the
Building Official, shall titute sufficient ground for the revocation of any permit issued which was based on the approval of this
a pplication.
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Signature of Applicant Date